=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811709488
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LISA CHRISTINE MORGAN MSN, RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/22/2025
-----------------------------------------------------
Last Update Date | 01/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1620 W HARRISON ST
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60612-3801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 312-947-1246
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1620 S. HARRISON ST TOWER- 12W RM 12416
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60612
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 312-947-1246
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 364SN0800X
-----------------------------------------------------
Taxonomy Name | Neuroscience Clinical Nurse Specialist
-----------------------------------------------------
License Number | 209029960
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------